Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug;30(4):571-578.
doi: 10.1177/15910199231162669. Epub 2023 Mar 14.

Endovascular treatment for anterior cerebral artery occlusions

Gokhan Ozdemir  1 , Fettah Eren  1 , Recep Aygul  1 , Nazım Kizildag  2 , Idris Kocaturk  3 , Azer Mammadi  1 , Ayse Nur Ersoy  1 , Omer Faruk Ildiz  1 , Zehra Betul Gunduz  4 , Muslu Kazım Korez  5
Affiliations

Endovascular treatment for anterior cerebral artery occlusions

Gokhan Ozdemir et al. Interv Neuroradiol. 2024 Aug.

Abstract

Background: We sought to examine the feasibility, safety and preliminary efficacy of anterior cerebral artery (ACA) occlusions in patients undergoing endovascular treatment.

Methods: Four hundred five consecutive patients with large-vessel occlusion treated with endovascular treatment were analysed to identify all patients with acute ACA occlusion who underwent endovascular treatment.

Results: Twenty had ACA occlusion (primary ACA occlusion: 9, rescue ACA occlusion: 11), 395 patients had other occlusions (internal carotid artery and MCA). The median [IQR] mRS score in the third month was significantly higher in the ACA-rescue occlusion group versus the ACA-primary occlusion group. The rate of haematoma in patients with ACA-occlusions was significantly higher compared with the ACA-primary occlusion group. Moreover, the three-month mortality rate was higher in patients with ACA-rescue than the patients with ACA-primary.

Conclusions: Although endovascular treatment can be considered in patients with primary ACA occlusions, our data suggest that future clinical trials are needed to determine the efficacy of endovascular treatment for ACA occlusions. Unfavourable outcomes in our study were considered to occur in the rescue ACA occlusions.

Keywords: ACA occulusion; Anterior cerebral artery; acute ischaemic stroke; endovascular treatment; mechanic trombectomy.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Female (52 years old) presented with right hemiparesis and aphasia. He was taken to the intervention at the third hour. Diffusion-weighted imaging (DWI) demonstrated a scattered lesion in the anterior cerebral artery (ACA) territory. Digital subtraction angiography (DSA) demonstrated left ACA-A1 cut-off (arrow) (a). Thrombectomy Device – APERIO®3.5–28 mm (arrows) (b). Achieve recanalisation on final angiogram (c).
Figure 2.
Figure 2.
Male (63 years old) patient had a right hemiparesis and abulia. Diffusion-weighted imaging (DWI) demonstrated an acute ischaemic lesion in left area of the anterior cerebral artery (ACA) territory. Digital subtraction angiography (DSA) demonstrated ACA-A2 cut-off (arrow) (a). Patient was treated with stent-retriever placement (arrows) (b). Achieve recanalisation on final angiogram (c).
Figure 3.
Figure 3.
Female (59 years old) patient had left hemiplegia and conjugate eye deviation. He was intervened with intravenous (IV) tPA at the third hour and angiography was performed half an hour later. Digital subtraction angiography (DSA) demonstrated anterior cerebral artery (ACA) cut-off (arrow) (a). In addition, the patient's right MCA M3 occlusion was also observed together with ACA (arrows) (b). Achieve recanalisation on final angiogram (c).
See this image and copyright information in PMC

References

    1. Jovin TG, Chamorro A, Cobo E, et al. Thrombectomy within 8 h after symptom onset in ischemic stroke. N Engl J Med 2015; 372: 2296–2306. - PubMed
    1. Bradac GB, Venturi F, Bosco G, et al. Acute occlusion of the distal internal carotid artery: single center experience in 46 consecutive cases, review of the literature and proposal of a classification. Clin Neuroradiol 2020; 30: 67–76. - PubMed
    1. Pfaff J, Herweh C, Pham M, et al. Mechanical thrombectomy of distal occlusions in the anterior cerebral artery: recanalization rates, periprocedural complications, and clinical outcome. AJNR Am J Neuroradiol 2016; 37: 673–678. - PMC - PubMed
    1. Uno J, Kameda K, Otsuji Ret al. et al. Mechanical thrombectomy for acute anterior cerebral artery occlusion. World Neurosurg 2018; 120: e957–e961. - PubMed
    1. Hudson JS, Gross BA. Anterior cerebral artery thrombectomy: a case series and technical description. Interdiscip Neurosurg Adv Tech Case Manage 2021; 26: 101331.

LinkOut - more resources